| Doctor Name: | DR. AGNELO B DIAS |
| NPI Number: | 1013139716 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ED. D., LCSW |
| License Number: | 73 079925 |
| Business Practice Address: | 2174 Hewlett Ave Suite 212 Merrick, NY - 115663606 |
| Business Phone Number: | 5165132678 |
| Business Fax Number: | 5164141953 |
| Mailing Address: | 595 Dogwood Ave, WEST HEMPSTEAD |
| State: | NY |
| Postal Code: | 115523128 |
| Phone Number: | 5164141953 |
| Fax Number: | 5164141953 |
| NPI Enumeration Date: | 05/03/2007 |
| NPI Last Update Date: | 11/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 73 079925 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |